Metro Heart and Vascular Institute, Metro Health Hospital, Michigan State University, Wyoming, Michigan.
Division of Cardiology, Department of Medicine, University of Miami Jackson Memorial Hospital, Miami, Florida.
J Am Coll Cardiol. 2015 Nov 17;66(20):2246-2255. doi: 10.1016/j.jacc.2015.09.055.
Due to recurrent right ventricular outflow tract (RVOT) dysfunction, patients with complex congenital heart disease of the RVOT traditionally require multiple surgical interventions during their lifetimes. Percutaneous pulmonary valve implantation (PPVI) has been developed as a nonsurgical alternative for the treatment of right ventricular to pulmonary artery stenosis or pulmonary regurgitation. PPVI has been shown to be a safe and effective procedure in patients with dysfunctional surgical RVOT conduits. In this population, PPVI has the potential to improve symptoms, functional capacity, and biventricular hemodynamics. However, limitations to the anatomical substrate and size of the RVOT currently restrict PPVI eligibility to less than one-quarter of patients with RVOT dysfunction. The current review discusses contemporary practices in PPVI, evidence supporting the procedure, and future technologies and developments in the field.
由于右心室流出道（RVOT）功能反复出现问题，传统上，患有复杂先天性 RVOT 心脏病的患者在其一生中需要多次手术干预。经皮肺动脉瓣植入术（PPVI）已被开发为治疗右心室至肺动脉瓣狭窄或肺动脉瓣反流的非手术替代方法。PPVI 已被证明在功能失调的外科 RVOT 导管患者中是一种安全有效的方法。在该人群中，PPVI 有可能改善症状、功能能力和双心室血液动力学。然而，目前 RVOT 的解剖学基质和大小的限制将 PPVI 的适用性限制在 RVOT 功能障碍患者的四分之一以下。本综述讨论了 PPVI 的当代实践、支持该手术的证据以及该领域的未来技术和发展。
